HITECH: Wedding IT to care delivery and payment reform
Experts say the federal HITECH Act should be "wedded to a strong commitment to provider payment reform" to push transformation in the nation's healthcare system.
Sen. Sheldon Whitehouse (D-R.I.) said the United States is at a junction that is both a historic opportunity and a threat to America's healthcare system.
"If we don't get this right... we are going to be up against some truly horrific choices," he said.
Judy Feder, a senior fellow at the Center for American Progress Action Fund, a liberal political policy research and advocacy organization, sees information technology as having a "tremendous" impact on this opportunity.
Peter Basch, medical director of ambulatory clinical systems at MedStar Health, a non-profit, community-based health system serving the Baltimore/Washington region, said there are clear benefits of having an electronic health record, but just having one won't bring about quality improvements. In order to generate value, he said, EHRs must provide preventive care measures, chronic disease management, care coordination, non-visit-based care (or "e-care") and knowledge-based medication management.
But before there can be widespread adoption of these EHR models, Basch points out that the payment system has to change to one that recognizes the quality of healthcare outcomes.
The current payment system "hinders innovations and leads to mediocre performance of existing healthcare IT systems," he said.
Without change, he said, there will be no business case for further developing EHRs.
Todd Park, a senior fellow at the Center for American Progress Action Fund, sees a three-part solution to fixing the system.
"We have to avoid seeing HITECH as just an EHR deployment," but also something that will help improve care, he said.
First, the initial standard for "meaningful use," he said, should have a results-oriented focus that will help improve care and accelerate payment reform.
Second, Park said there should be widespread achievement of meaningful use by healthcare providers. One way to do this is through Regional Health IT Extension Centers (RHITECs) that can help healthcare providers who serve the underserved or lack the expertise and resources to purchase, install and use information technology.
Third, Park advocates tight coordination of the health IT program with provider payment reform. The quality metrics desired by Medicare to power payment reform should directly inform the definition of "meaningful use" and, in turn, the data collected via the spread of "meaningfully used" health IT should help power the development and refinement of reformed payment models, he said.